WHAT I FIND MOST CHALLENGING ABOUT THE FIELD

Many companies will measure a pharmacist’s productivity by the number of medication orders verified in a given day. This is a sad reality in many pharmacy settings because the profit margins are slim, with constantly decreasing reimbursements from the insurance companies. The chain pharmacies, in particular, are notorious for monitoring pharmacists’ numbers.

Where I work, it isn’t quite as oppressive, but still, when I started out at my current job, I was frequently conflicted between the volume of orders that I was expected to verify, and taking the time to intervene on interactions and allergies that could affect the patient’s health. I had to find a balance between patient care and satisfying the job requirements.

Another challenge is the schedule: Because most pharmacists work in settings that operate 24/7, many shifts, especially when starting out, are late nights and Sundays. My husband would come home early from yeshivah or work one or two nights a week to watch the kids, and Sundays were a patchwork of coverage between grandparents and babysitters. Thankfully, along with seniority has come a more manageable schedule. I currently work normal business hours, with only an occasional Sunday.

I’LL NEVER FORGET WHEN

A few years ago, one of the pharmacy technicians came over to me and some of the other pharmacists and said she felt sick. She was sweating and felt faint, and someone called an ambulance. While we waited for the paramedics to arrive, her breathing became labored, and she was wheezing loudly, obviously in pain. The other pharmacists and I looked at each other, and we agreed that she was probably having an allergic reaction and needed an epinephrine injection. I ran to the medication shelves, injected her with an epi-pen, and after a minute her breathing began to ease. In the hospital, she was told she’d had a severe allergic reaction and may not have survived had she waited 15 minutes for the paramedics to arrive before receiving epinephrine.

HOW WE WERE AFFECTED BY COVID-19

During the height of the pandemic in our area, there were many medications that nursing home residents needed urgently for treatment and supportive care, and our pharmacy was very busy. Other than those weeks, the work has been largely the same as usual. Some pharmacists have been able to work remotely from home answering calls and verifying medication orders, but those who have to check that the final product was packaged accurately have to work in the pharmacy.

SOMETHING I WISH PEOPLE KNEW ABOUT PHARMACISTS

People don’t realize how many different settings pharmacists work in. Most people know about retail pharmacists who check medications in community pharmacies, but pharmacists also work to make clinical medication decisions in hospitals, to design medication coverage plans for insurance companies, and in drug trials and medical writing for drug manufacturers.

MY ADVICE FOR PEOPLE STARTING OUT

Most pharmacists go through school with a specific practice setting in mind, and may focus on classes relevant to that field more than others. But depending on where you live, pharmacist jobs can be difficult to find upon graduation. So keep an open mind, because you never know where that will take you. One of my good friends in pharmacy school wanted to get a job as a clinical pharmacist in a hospital, but after six months of unsuccessfully seeking a position, she accepted a job with an insurance company. She ended up being promoted to the medical writing department, and is thrilled to be where she is.

MAYER GOLDBERG, Woodmere, NY

Clinical Pharmacy Specialist Kingsbrook Jewish Medical Center (KJMC), Brooklyn, NY

Graduated from, Touro College of Pharmacy

Years in Field, 4

MY TYPICAL DAY AT WORK

As a clinical pharmacy specialist in emergency and surgical medicine, some of my responsibilities include monitoring patient adherence to therapy (for example, by monitoring how often they fill their medications to check that they’re taking their meds as often as they’re supposed to), providing medication information for medical professionals, monitoring patient laboratory values, and educating patients about their medications. Additionally, I play an active role in the professional development of KJMC’s pharmacy residents.

I start rounding with the surgical and emergency teams every morning at 7:30 a.m. I work with the medical staff to ensure patient safety with the prescribing, dispensing, and administration of medication. I’ve also been playing a critical role in patient security in the emergency department. Since it can become chaotic, the ED is more prone to medication errors. I review the patients’ home medications to ensure patients can safely use the medications prescribed by the ED physician. I also work in the surgical department, particularly in the pre-op and post-op stages, to ensure appropriate antibiotic use. I respond to medical emergencies such as rapid sequence intubations, cardiac arrests, and strokes to assist in the retrieval and appropriate use of high-alert medications.

WHY I CHOSE THE PHARMACY PROFESSION

I always wanted a career in healthcare — I wanted to help people recover from illness. At the same time, I wanted to have the flexibility to help patients either on the individual level, such as in hospital settings, or on a more global scale, as in pharmaceutical research. The variety of career opportunities for a pharmacist really spoke to me.

WHAT I LOVE MOST ABOUT THE FIELD

The field is rapidly changing, and even old medications are being repurposed for new diseases, in addition to the development of new medications. Since pharmacy is ever evolving, there are no two days that are alike. Every day brings up new challenges that require one to think out of the box — such as what to do when there’s a shortage of a certain drug, a quite common occurrence.

WHAT I FIND MOST CHALLENGING ABOUT THE FIELD

I work at a small, 303-bed community teaching hospital. The small size often makes it challenging to acquire certain important medications that are on backorder, and then alternative medications need to be sought. The hospital is currently undergoing a merger with Interfaith and Brookdale, known as the One Brooklyn Health System. As a result, there is a larger focus than usual on saving costs, which can be quite difficult when working in the emergency department, where the fast-paced nature leads to medication waste — either by a staff member dropping the medicine, or by a patient refusing to take it.

I’LL NEVER FORGET WHEN

A 46-year-old patient with an unremarkable medical history developed an out-of-hospital cardiac arrest and was brought to our emergency department. After several rounds of CPR and epinephrine, the patient regained his pulse but still didn’t regain consciousness. After a quick consultation among the medical staff, we placed the patient on targeted temperature management: the cooling of the overall body temperature to 33–36 degrees Celsius to preserve brain function. During the cooling and re-warming phases, it’s imperative to monitor the patient closely for shivering and for electrolyte imbalances. This monitoring was my job. I also ensured that the physicians ordered the medication necessary to facilitate this procedure. The patient did have several electrolyte abnormalities which we were able to manage effectively, and he ultimately woke up and survived.

HOW WE WERE AFFECTED BY COVID-19

COVID-19 was extremely difficult on all healthcare professionals. Our emergency department can accommodate approximately 30 to 35 patients on a daily basis. However, during the pandemic we were averaging 80 to 85 patients daily. There is rapidly changing information about effective treatments or certain medications to avoid, and it’s essential for pharmacists to keep up to date and ensure medication safety.

SOMETHING I WISH PEOPLE KNEW ABOUT PHARMACISTS

The field of pharmacy has evolved over the years; pharmacists today don’t just count pills. Aside from screening patients medications for drug-drug interactions, they may also administer many essential vaccines.

MY ADVICE FOR PEOPLE STARTING OUT

Use the opportunity that pharmacy schools offer to enhance your communication skills during rotations. Many rotations offer the opportunity to interview and counsel patients about their medications, which is an invaluable skill. Challenge yourself in school to the fullest extent, because once you graduate and are working alone on the job, real people’s lives are at stake.

LEORAH TAAVAR, Brooklyn, NY

Pharmacist and Owner, Modern Remedies Pharmacy, Brooklyn, NY

Graduated from, Long Island University

Years in Field, 3

MY TYPICAL DAY AT WORK

As a pharmacist in the retail setting, my responsibilities are to verify prescriptions, to make sure there are no drug interactions between any of the patients’ prescriptions, to counsel patients on how to take their medications properly, and to answer any of their concerns. We also make sure that the prescriptions are the correct dose for the diagnosis.

A typical day involves me typing and verifying prescriptions, answering a lot of phone calls, making countless phone calls to doctors, patients, and insurance companies, and getting out the prescriptions in a timely manner to keep customer satisfaction. One of the advantages a private store has over big chain stores such as Walgreens and CVS is that we can work a lot more efficiently, getting our customers in and out as quickly as possible.

WHY I CHOSE THE PHARMACY PROFESSION

I’d always wanted to go into the medical field but didn’t want to get into anything too physically involved with patients. Also, as a Jewish mother, pharmacy offers flexible positions and schedules, unlike many other jobs in the medical field.

HOW I CAME TO OPEN MY OWN PHARMACY

The option to open a business was always on the table but wasn’t something we were thinking of doing so soon. Sometimes Hashem puts the right opportunity in front of you and you need to grab it. In my case, the father of a friend of mine had owned a pharmacy and was looking to retire. Looking back, I’m shocked that we were able to do this, but I would definitely encourage others to start their own businesses. It may be difficult at first and will involve many sacrifices, but ultimately there is an enjoyment you get going to your own business every day versus working for someone else.

Of course, running your own business requires a certain skill set apart from that of a pharmacist. For any retail business, I think the most important skill you need is to be personable and outgoing. Also, having a good finance background is a plus. Unfortunately, I don’t have this, though I wish I did.

WHEN I NEED TO CHANGE THE DOCTOR’S PRESCRIBED MEDICATION

There is some leeway when it comes to recommending a different medication than the one the doctor prescribed. Obviously, the physician is the one who has the final say in a prescription, but we call doctors all the time and give recommendations. Usually it’s due to insurance not covering a particular medication.

WHAT I LOVE MOST ABOUT THE FIELD

It’s so gratifying to see patients get help! For our elderly patients, in particular, their lives often depend on these medications, and they literally depend on us for their daily survival. That’s something you don’t get working in other industries.

WHAT I FIND MOST CHALLENGING ABOUT THE FIELD

When a patient’s prescription is not covered by insurance or when we cannot get through to the doctor to refill a prescription. Remember, a lot of patients feel a sense of urgency that their lives depend on the medication.

I’LL NEVER FORGET WHEN

One Friday afternoon, a friend called me frantically saying that a real danger in her state, and that she didn’t want to wait until after Shabbos to get the medication. Being that all the Jewish pharmacies were closed, her doctor had sent the medication to CVS but the line in CVS was very long and there was no way they would get it before Shabbos. I told her to come to my store as soon as possible. I quickly got in my car, got the doctor on the phone to verify the strength she needed, and baruch Hashem got her the medication on time for both of us to light candles.

HOW WE WERE AFFECTED BY COVID-19

Ultimately, my job per se was not affected by COVID, but during the peak of the pandemic, we were extremely busy with panicked patients trying to stockpile enough medication for the next ten years. There were also a lot of steps to overcome in getting those 30 pills into the bottle.

SOMETHING I WISH PEOPLE KNEW ABOUT PHARMACISTS

That we’re not just pouring pills from one bottle to the next! I get a lot of people asking me why it takes so long to get their medications filled. There are a lot of obstacles in the way of getting those 30 pills into the bottle!

MY ADVICE FOR PEOPLE STARTING OUT

Be prepared — the transition from student to pharmacist can be terrifying. I remember looking at every prescription a hundred times the first day and calling all my friends asking them which interactions required interventions and which didn’t.

Don’t get discouraged by failure, particularly if you’re a business owner. As religious Jews, we should always keep in mind that we don’t always see the full picture. I’ve wasted time, energy, and money on certain projects to market our pharmacy business which in the end looked like total failures — only to realize later on that the process was for the best.

(Originally featured in Mishpacha, Issue 818)